Job Description

The primary role of the job is to assist in the oversight of HEDIS operations and training including but not limited to data abstraction and entry, fax conversion and provider outreach.

Essential Functions

• Ensures the team is updated with the quality guidelines from NCQA
• Protects the confidentiality of member information and adheres to company policies regarding confidentiality
• Ensures the team's understanding and use of information system capability and functionality
• Select staff using clearly defined requirements in terms of education, experience, technical and performance skills
• Assesses developmental needs and collaborates with others to identify and implement action plans that support the development of high performing teams
• Establish an environment and work style that promotes the concept of teamwork, cross product integration, and continuum of care thinking that results in strong performance
• Articulate performance expectations and team objectives while collecting and interpreting balanced measure to evaluate individual staff and team performance
• Lead change efforts while managing transitions within a team
• Create a positive work environment by acknowledging team contributions, soliciting input, and offering personal assistance, when needed
• Assists in maintaining compliance with Human Resource policies and procedures and implements them at the employee level
• Conduct trainings (new hire or otherwise)
• Knowledge management

Performance Parameters

SLAs on target

Personal Attendance

Quality and accuracy of reports and materials

Adherence to internal standards

Quality and effectiveness of training when applicable

Training Administration when applicable

Interaction with the clients at an appropriate level to ensure high levels of client satisfaction

Education Requirements

• Graduate of bachelor of Science in Nursing
• Philippine Registered Nurse

Work Experience Requirements

• Minimum of 1 year in bedside nursing experience (primary, secondary or tertiary hospital)

BPO experience (desired but not required)

Eligibility Criteria:

• Candidates must have minimum one year tenure in EXL and in the current role
• Should not be on PDP/Disciplinary action within 6 months from date of NOD. Please see Progressive Disciplinary Policy for further details
• Should not be on PIP during the time of application.
• Candidates must have an average of 4.0 & above rating (Goal & Competency or Composite Rating) for the last 6 months
• Must have no issues on Attendance and Reliabilities
• Positive feedback from local leadership and their leadership teams